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Job Summary This position is responsible for ensuring compliance with Utilization Management (UM) and Quality Review (QR) functions performed by the health plan. The role supports clinical review activities requiring 5+ years of...

Clinical Review Nurse - Prior Authorization Various, NV Clinical Review Nurse - Prior Authorization Various, NV All On-site Location: Fully Remote – Prefer Candidates reside in NV, but can reside elsewhere if they...

The Virtual Nurse, RN at MUSC coordinates and delivers professional clinical, quality, and educational services to patients engaging with MUSC via virtual care. This role reports to leadership within the MUSC Center for Telehealth and aims to...

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold...

Machinify is seeking a Medical Review Nurse to perform CMS/RAC audits for government payers. This remote role involves working with a multi-location team to review claims, document findings, and support appeals. RAC certification is preferred and...

Care Career is seeking a travel nurse RN Labor and Delivery for a travel nursing job in Los Angeles, California. Job Description & RequirementsSpecialty: Labor and...

Fully Remote: Clinical Documentation SpecialistFacilitate the improvement of clinical documentation by collaborating with physicians, nursing staff, and other patient caregivers. Perform concurrent and retrospective reviews of medical records to...

Come care with us at West Coast University! As a Nursing Academic Specialist for a certified Great Place to Work, you will guide nursing students to do more than change their own lives – you will help change the lives of...

About the Job ASSIGNMENT SUMMARY: The Registered Nurse (RN) will be responsible for coordinating, implementing and supervising all nursing and personal care services at the Adult Day Health Care Center. The...

Review NurseThis is a contract assignment that will start right away and end on April 30th 2024Summary Description:The review nurse is responsible for medical record abstractions and overreads during the annual Healthcare Effectiveness Data and...

School Nurse Under direction, to provide basic health services to students; to assist in the planning and implementation of school health programs in cooperation with medical authority and school administrative personnel; to evaluate the...

GQR Healthcare is seeking a travel nurse Correctional for a travel nursing job in Downey, California. Job Description & RequirementsSpecialty:...

Facilitates the provision of timely and effective patient care under the supervision of licensed members of the healthcare team. Helps maintain a safe and clean environment in order to enhance department operations. Patient care is delivered...

Masimo is seeking a Clinical Research Lab RN to join our team in Irvine, CA. You will perform venous sampling, IV placement, and arterial-line tasks while supporting R&D funding, regulatory filings, and marketing initiatives for Masimo products.

Southcoast Health seeks a Team Lead-Centralized Clinic Support to join a remote role serving MA/RI communities. The role guides nursing staff, ensures clinical workflow compliance, and drives care coordination and patient safety across ambulatory...

Job Title: Clinical RN Job ID: 90637 Location: North Hollywood, California Overview: Are you a dedicated Registered Nurse who excels in outpatient clinical care and thrives in a...

Ethos Risk Services is seeking a full-time Clinical Recruiter (REMOTE) to lead hiring for the Case Management division. You will own full-cycle recruiting for nurse case managers and other clinical pros, from posting to onboarding, ensuring a...

CVS Health is recruiting for an RN Concurrent Review Nurse in a remote capacity, focusing on inpatient clinical expertise to ensure medically necessary care across the continuum. The role requires an active RN license and 5+ years of...

TEEMA Group is seeking a Clinical Quality Reviewer (RN or LCSW) for remote work in approved states. This role focuses on reviewing clinical cases, identifying quality or safety concerns, and supporting quality improvement initiatives across a...

Centene Corporation is seeking a Licensed Practical Nurse (LPN) or Registered Nurse (RN) for a remote case management role in Pennsylvania. The selected candidate will perform concurrent reviews, determine appropriate care levels, and assist with...

HealthHelp, a WNS company, seeks a Clinical Review Nurse for a fully remote role in the United States. You will perform prospective reviews for medical necessity on prior authorization requests across multiple specialty programs and refer...

Who We Are: Since 1985, BHCHP's mission has been to provide or assure access to the highest quality health care for all individuals and families experiencing homelessness in greater Boston. We care for over 11,000 homeless individuals each...

Schedule: Flexible Shifts! You provide your manager with the days and start/end time you are available to complete your hours. All United States time zones are welcome. PRN opportunity to work 20-30hrs per week Job Location Type:...

Resp & Qualifications We are looking for an experienced professional to work remotely from within the greater Baltimore metropolitan area. The incumbent will be expected to come into a CareFirst location periodically for...

Description Our Certified Nursing Assistants (CNAs) actively incorporate our "Philosophy for Person-Directed Care." You would develop awareness of residents' interests and needs, and assist residents to maximize their independence and...